Highlights
- •Fractional anisotropy correlates with the FIM motor score in the good recovery group during postacute stroke.
- •Fractional anisotropy does not correlate with the FIM motor score in the poor recovery group during postacute stroke.
- •Fractional anisotropy may serve as an imaging biomarker during the stroke recovery process.
Abstract
Objective
To investigate the relation between fractional anisotropy (FA), a suggested biomarker
for tissue integrity, and motor recovery in patients with stroke after postacute rehabilitation.
Design
Retrospective study.
Setting
Acute rehabilitation hospital.
Participants
Subjects (N=43) diagnosed with ischemic stroke (n=28) and hemorrhagic stroke (n=15).
The average age for subjects was 68±14 years.
Interventions
Magnetic resonance imaging and diffusion tensor imaging were conducted on all patients.
Main Outcome Measures
The admission and discharge motor subscores of the FIM were obtained from medical
records, and relative gain was calculated using the Montebello Rehabilitation Factor
Score (MRFS). K-means cluster analysis (K=3) using both the MRFS and the gain of the
FIM motor subscore (ΔFIM) was performed. Analysis of variance was used to determine
the difference in FA among the clusters. Spearman analysis was conducted to examine
the relation between FA, ΔFIM, and MRFS in each cluster.
Results
FA was significantly higher in the clusters of good and moderate recovery in the corticospinal
tract (CST), peduncle, and posterior limb of the internal capsule bilaterally (all
P<.05) compared with the poor recovery group. Significant positive correlations were
observed in multiple regions along the CST between FA, ΔFIM, and MRFS in the clusters
of good and moderate recovery, but not in the poor recovery group.
Conclusions
Our results showed an association between FA values within the corticospinal tract
and motor recovery in patients with stroke undergoing postacute rehabilitation. This
finding may help to identify novel targets for new interventions to promote stroke
recovery.
Keywords
List of abbreviations:
ANOVA (analysis of variance), CST (corticospinal tract), DTI (diffusion tensor imaging), FA (fractional anisotropy), MD (mean diffusivity), MRFS (Montebello Rehabilitation Factor Score), MRI (magnetic resonance imaging), ROI (region of interest)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: May 10, 2016
Footnotes
Supported by the Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health award no. UL1 TR001102); Harvard University and its affiliated academic health care centers; and Fundamental Research Funds for the Central Universities (grant no. 12ykpy39).
The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University, and its affiliated academic health care centers or the National Institutes of Health.
Disclosures: R.Z. receives book royalties from Demos, personal fees for an educational video from Oakstone, and serves in the scientific advisory board at Oxeia Biopharma. The other authors have nothing to disclose.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
